Stigma, Mental Health, and Health care Use Among Rural Sexual and Gender Minority Individuals

Abstract

Sexual and gender minorities (SGM) frequently experience depression and health care-related stigma. Health care satisfaction is important for seeking care, but little is known about SGM health care satisfaction, and especially as it relates to depression among rural SGM. From May 25 to July 2, 2021, we surveyed rural Illinois (IL) individuals aged ≥18 years on the topics of demographics, depression, health care satisfaction, past health care experiences, internalized stigma, and victimization. Among the 398 respondents, the gender identity distribution included cisgender males and females (171 and 203, respectively) and transgender males and females (8 and 7, respectively), while sexual orientation included heterosexuals (114), gay/lesbians (143), and other orientations (141). Analyses were conducted with respect to both identity and orientation (and their interaction). In univariate analysis, transgender individuals were more likely than cisgender to screen positive for depression and less likely to report feeling accepted by their medical provider. Compared to heterosexual respondents, gay/lesbians and other orientations were more likely to screen positive for depression. In logistic regression, factors associated with increased risk of depression included nonheterosexual orientation and past poor health care experiences. In linear regression, factors most commonly associated with the seven satisfaction subscales include: sexual orientation, past poor experiences, and employment. There were significant differences in depression across both sexual orientation and gender identity, and in health care satisfaction by sexual orientation. Rural SGMs are more vulnerable to depression and less likely to report satisfactory care. As health care engagement is critical for screening and care adherence, engaging rural SGM in a routine and satisfactory fashion is needed.

The Relationship between Minority Stress and Depressive Symptoms in the LGBTQA Population from Poland

“…There is also the interaction between gender and sexual identity and decreasing mental health and wellbeing in the LGBTQA population. Higher depression rates were found in this study in dual than single SGM people (71.1% vs. 58.3%, respectively), which is in line with other studies [ 22 , 34 ]. Therefore, the double SGM population should be a target group for mental health prevention and intervention programs.…”

“…Furthermore, we will explore the diversity in gender and sexual identity concerning depression and minority stress. Consistent with the previous literature, we hypothesize that high minority stress and depression will be presented in dual SGM individuals [ 22 , 28 , 30 , 34 ] (bisexual and pansexual people) [ 13 , 20 , 22 , 35 , 36 ], and women [ 14 ]. The associations between depression as an explained variable and such predictors as SGM identity and minority stress will be examined using logistic regression analysis.…”

“…Therefore, intolerance of LGBTQA people is high and stoked by the current government of law and justice, which can explain higher depression rates among LGBTQA adults from Poland compared to those from Spain or the USA [2,12]. However, both the current and previous studies show that a significantly higher depression risk is presented among people representing SGM than among heterosexual and gender-conforming individuals [14,16,17,20,21,34]. Therefore, prevention and intervention programs should be developed for the LGBTQA population.…”

“…Moreover, a younger age may be related to even higher depression rates [ 19 , 33 ]. Depression risk may also be higher among dual SGM participants (than single sexual or gender minority) [ 22 , 28 , 30 , 34 ], bisexual persons (compared to LG) [ 13 , 20 , 22 , 35 , 36 ], and among females (than males) [ 14 , 37 , 38 ]. However, the relationship between distress and the gender of minority samples is ambiguous.…”

Georgia Health Care Providers’ Experiences With Community Public Health Clients

“…While mental health concerns impact all members of society, studies have shown that mental health issues tend to affect members of sexual and gender minority communities at a greater level (Bränström et al, 2022;Jenkins et al, 2022;Kerr et al, 2022;Pease et al, 2022;N. S. Perry & Nelson, 2022;Pharr et al, 2019;Tabler et al, 2019;Tuthill et al, 2017).…”